Methods

Patients having cancer surgery (general surgery, gynaecology, urology) were assessed for clinically overt VTE occurring up to 30±5 d after intervention or more if the hospital stay was longer. All suspected VTE events were evaluated by an external independent Adjudication Committee.

Results

A total of 2373 patients, 1238 (52%) undergoing general surgery, 685 (29%) urologic, and 450 (19%) gynaecologic surgery were evaluated. In urologic patients, most procedures (61%) were endoscopic, with bladder and prostate cancer being the most frequent tumours. In-hospital thromboprophylaxis was given to 71.7% of patients, whereas 32.5% received prophylaxis after discharge. The incidence of VTE in urologic patients was lower (0.87%) than that in general surgery and gynaecologic patients (2.8% and 2.0%, respectively). VTE consisted of three cases of nonfatal and three cases of fatal pulmonary embolism (PE). In four of the six cases, VTE occurred during prophylaxis.

Conclusions

VTE still represents a severe complication and remains the most common cause of death after urologic cancer surgery. Efforts should be made to optimise prophylactic measures to further reduce such risk.

Roberto M. Scarpa, Giuseppe Carrieri, Gualberto Gussoni, Andrea Tubaro, Giario Conti, Vincenzo Pagliarulo, Vincenzo Mirone, Antonello De Lisa, Gaspare Fiaccavento, Luigi Cormio, Erminio Bonizzoni, Giancarlo Agnelli

Division of Urology, University of Turin, Orbassano, Italy
Division of Urology, University of Foggia, Foggia, Italy
Scientific Department, Italfarmaco S.p.A., Milan, Italy
Department of Urology, 2nd School of Medicine, “La Sapienza” University, Rome, Italy
Division of Urology, St. Anna Hospital, Como, Italy
Department of Urology II, University of Bari, Bari, Italy
Department of Urology, University “Federico II”, Naples, Italy
Division of Urology, University of Cagliari, Cagliari, Italy
Department of Urology, Portogruaro Hospital, Portogruaro, Italy
Institute of Medical Statistics and Biometry, University of Milan, Milan, Italy
Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy

Accepted 13 July 2006 published online 31 July 2006.